Although I can understand why people want to test their blood glucose levels the reality is that there is no robust, conclusive evidence that it improves diabetes control for those with type 2 on diet/diet and metformin. The NHS is in crisis finacially and will not fund interventions for which there is no evidence, this is for any healthcare intervention, for any condition, not just diabetes. Even on diabetes UK, where they advocate testing, they admit that numerous studies have failed to produce evidence that bg testing improves control for T2 on diet/metformin, and that HbA1c remains the gold standard in monitoring for this group of patients. They justify the use of blanket testing by saying it makes people feel better and more in control, but this does not justify the huge financial cost of funding. The reality is that it is impossible for the NHS to fund the cost of treatments that have no evidence base, there just isn't the money. As another poster pointed out, if you don't qualify for the strips on the NHS you can always buy them yourself. Many people with health conditions do not get free prescriptions and have to pay charges for their medication every month. People with diabetes are fortunate in the sense that they qualify for free prescriptions, but I really don't see why this should extend to a very costly intervention for which there is a lack of supporting evidence. You do not need bg testing to see how foods will affect your bg levels. We already know what foods will do this without testing - carbohydrates. Evidence does show that the best way to manage T2 diabetes on diet/metformin is to limit your carbohydrate intake (and in general eat healthily), participate in moderate physical activity, and have regular HbA1c tests. The carbohydrate content of foods is easily obtainable, if you aim for 40 to 50 grams of carbs with each meal, with maybe 10 to 20 gram carb snacks either side, this is a good basic starting point for most. If after so many months a sensible diet and some moderate exercise has not brought your HbA1c down then there would be justification to use bg testing to improve control. But blanket prescribing for every single person with T2 diabetes is unjustifiable and unsustainable. on the issue of hypoglycaemia, of course people who are at risk of hypos should without question have access to bg testing, but T2 on diet/metformin do not fall into this category. I am not saying it is impossible to suffer with hypoglycaemia on diet/metformin, but it is rare. As for hyperglycaemia, again, this can be prevented with sensible carbohydrate intake, and the odd high blood sugar is not harmful. All the evidence shows that it is persistent hyperglycaemia, evident from continually poor HbA1c results, over a number of years, that contributes to the serious complications associated with T2 diabetes. I do feel that in an ideal world it would be great if everyone with diabetes could test their bg levels, as people clearly feel it helps them, but in a world where the NHS restricts proven drugs for cancer patients because it "only adds a few weeks or months onto their lives" then a reality check is needed, blanket bg testing is just not going to happen, not because the NHS has it in for diabetics, but because there simply isn't the money for an intervention with no supporting evidence. My family is blighted by T2 diabetes and we often discuss the issue of bg testing, and when I have suggested buying the strips if it is felt to be so important for their health, paying 20 pounds a month, the issue of being unable to afford it inevitably comes up, yet they all pay around 100 quid a month for their sky tv packages! If and when the evidence becomes available that bg testing is an essential part of the management for all T2 diabetes it should be fully supported, as it is for now, it is a preference, not a need, and therefore must be funded from your own pocket.
I'm off to recuperate! Haha.
